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Abstract

Main objective
The Leijpark Rehabilitation Center in the Netherlands offers an Early Intensive Neurorehabilitation Program (EINP) to children and young adults in a long-term unconscious state after severe brain injury. The effects of EINP were studied in an extensive research project. This part of the project focused on the outcome in terms of level of consciousness (LOC) in relation to the specifics of a retrospectively studied cohort.

Design of the study
This study was conducted according to an archived single-group pre-test-post-test design.

Subjugate 
The subjects were all successively admitted patients (n 1/4 145, 72% men) between December 1987 and January 2001. Inclusion criteria were: age 0-25 years, within 6 months of injury, LOC at inclusion vegetative state (USA) or minimally conscious state (MCS). One hundred and four patients (72%) suffered a traumatic injury and 41 patients (28%) a non-traumatic injury.

Methods and procedures
All patients had received EINP until they regained consciousness or until it was concluded that no progress was made for 3 months after initiation of EINEP. Medical records were examined to collect the characteristics and injury data of the patients, to determine the LOC at admission and at discharge, and to determine the discharge destination.

Results 
Almost two-thirds of the patients regained full consciousness. LOC at admission, etiology and interval since the injury were found to be significant prognostic factors. Traumatic patients had a much better outcome than non-traumatic patients. A comparison with previous outcome studies showed a more favorable outcome than expected. It is argued that a multicenter study is needed to confirm potential effects of EINP.

Keywords
Severe Brain Injury, Children, Young Adults, Outcome, Early Intensive Neurorehabilitation, Vegetative State, Minimal Consciousness